Comparison of Cardiac Function Evaluation by 128-Slice Single Source Retrospectively Gated Cardiac CT and 2D/M- mode Echocardiography.

Aims: To study the correlation of Cardiac function/ejection fraction derived from 128 slice MDCT (multi detector computed tomography) results with those of functional data from 2D/M-mode echocardiography. Study Design: Retrospective, comparative study with empirical data. Place and Duration of Study: Department of Radiology at K. Govindaswamy Naidu Medical Trust hospital, Coimbatore, between May 2013 and October 2013. Methodology: For this study, 44 patients (M: F = 35: 9; mean age = 49 years) were randomly chosen who had come between May 2013 and October 2013. All the patients were referred to our department from cardiology as well as non-cardiology OPD’s for coronary CT angiography. Ejection fraction data was obtained using two methods; M-mode echocardiography and 128-slice MDCT using retrospective ECG gated coronary angiographic study. Results: The mean of LVEF (left ventricle ejection fraction) by echo is 64.73 with standard deviation of +/- 5.48 and the mean of LVEF by cardiac CT is 65.18 with standard deviation of +/- 8.70 with P- value of 0.770 (P value ranges from 0-1) which shows good correlation. The evaluation of LVEF by linear regression analysis show good correlation between LVEF by echo and MDCT. (r= 0.486). [r value ranges between -1 and +1]. Conclusion: This study shows the cardiac function evaluation using 128 slice MDCT is as good as the 2D- echocardiography thus the results are interchangeable between the modalities.

Paraganglioma of the urinary bladder: A clinicopathologic spectrum of a series of 14 cases emphasizing diagnostic dilemmas.

Background: Paraganglioma (PG) of the urinary bladder is a rare neuroendocrine neoplasm, accounting for < 0.1% of all bladder tumours. Distinction from urothelial carcinoma is imperative as management and prognosis vary markedly. In this report, we describe our experience with the histopathology of paragangliomas of the urinary bladder with emphasis on the histologic features that have led to their being misdiagnosed as conventional urothelial cancer and, most importantly, those that will help pathologists recognize this rare tumor of the bladder. Materials and Methods: All cases of PG of urinary bladder diagnosed at our institute from 2002-2012 were retrieved and diagnosis confi rmed in accordance with WHO classifi cation. Clinical and treatment details were obtained from hospital medical records. Results: Fourteen cases of PG of urinary bladder including 5 consult cases were analysed. These included 11 transurethral resections ± partial cystectomies, 2 partial cystectomies and 1 radical cystectomy. Two out of the 5 consult cases had been submitted with a diagnosis of urothelial carcinoma and 1 with that of a rhabdomyosarcoma. Age ranged from 15-84 years (median, 43 years) with a male to female ratio of 1:2.5. Presenting symptoms were haematuria, dysuria and fl ank pain; only 1 case had antecedent hypertension. Histologically, typical ‘zellballen’ (72%), diffuse (21%) and ribbon-like (7%) growth patterns amidst a richly vascularised stroma were seen. Muscularis propria invasion and necrosis was present in 72% and 21%, respectively. Substantial cautery artifacts led to misdiagnosis in the 3 erroneous cases. Tumour cells were positive for chromogranin, synaptophysin; sustentacular cells were S-100 positive. Follow up was available in 6 patients; median follow-up was 29 months (8-120 months). One patient developed distant metastasis in cervical lymph node 10 years after diagnosis; remaining were alive without evidence of disease. Conclusions: Paraganglioma of the urinary bladder is a rare tumor and may be misdiagnosed as urothelial cancer especially on TURBT, but a high index of suspicion, careful search for the characteristic histological features and supportive immunohistochemical studies should lead to a correct diagnosis

Uterine smooth muscle tumors of uncertain malignant potential and atypical leiomyoma: A morphological study of these grey zones with clinical correlation.

Objectives: To study the histological features in uterine STUMP, and atypical leiomyomas (AL), and to correlate with clinical outcome. Materials and Methods: From January 2004 to August 2010, a total of 21 cases were retrieved from records, labeled as STUMP(7), AL (5), AL with low risk of recurrence (2), smooth muscle tumor of low malignant potential (STLMP) (2), and symplastic leiomyoma (5). The slides were reviewed for coagulative tumor cell necrosis (CTCN), hyaline necrosis/ infarction type necrosis, presence and degree of cytological atypia, mitotic activity, epithelioid morphology and myxoid features. The other characteristics (such as size, circumscription, individual tumor cell necrosis), were noted, wherever available. Results: The mean age was 45 years (median 46; range 24-67 yrs). CTCN was seen in 2 cases on examination of additional material; wherein a revised diagnosis of leiomyosarcoma had been given. Infarction type necrosis and individual cell necrosis was seen in 2 and 3 cases, respectively. Mitoses were less than 5/10hpf in all the cases. One of the tumours labeled as STUMP also had concurrent endometrial adenocarcinoma. Follow up: Follow-up was available in 11 cases (52.3%). One patient had died. (cause not known). In 10 patients, the follow-up ranged from 4 to 56 months (mean 20.9 months; median 15 months) nine patients were alive and well. One patient (labeled STLMP) had metastatic liver disease 3 yrs after the primary surgery, at the last follow-up. Conclusions: 1) There is an overlap in using the terminologies as STUMP, AL, AL with low risk of recurrence, AL with low malignant potential. A designation of STUMP does convey a category of borderline malignancy to the gynecological surgeons. Most behave in a benign fashion and follow-up without adjuvant therapy is currently recommended. Critical evaluation of coagulative tumor necrosis is essential. Follow-up remains a challenge in our setting.

In vitro Evaluation of Antibacterial Activity of Various Crude Leaf Extracts of Indian Sacred Plant, Ocimum sanctum L.

The medical world is on an immense requirement to discover novel antibiotics due to widespread emergence of resistance among microbial pathogens against currently available antibiotics. Traditional plants have been proved to be better source in the search for novel antimicrobial compounds. In such effort, we accessed the susceptibilities of some clinically significant bacterial species against various extracts made up from leaves of Ocimum sanctum L. (family: Lamiaceae). Antibacterial activity of crude extracts was found to be reliant on the nature of extract and the bacterial strains evaluated. Methanol extract was found to have comparatively higher activity than other organic and aqueous extracts. Grampositive bacteria showed variable susceptibilities while Gram-negative Salmonella typhi has shown to be completely resistance to all the tested extracts. Minimum inhibitory concentration data showed hopeful results as some of the extracts exhibited significant inhibitions of bacteria even at low concentrations. This study indicated that leaves of Ocimum sanctum L. have significant antibacterial activity and it could be very useful in the discovery of novel antibacterial/antimicrobial agents.